Sleep is a an essential physiological function of the human body. Sleep plays a very important function in restoring the wear and tear of daily life and providing the desired rest and restitution to the body and mind. As we grow older, the quality of our sleep may change. When we are younger as in childhood we tend to have more hours of sound sleep but as we grow older the number of hours we sleep and the quality of sound sleep can deteriorate significantly.
Moreover, the demands of work, professional deadlines, travel stress, physical ill health, excessive gadgets usage before bedtime, mental stress, all of these can contribute towards poor sleep! Some of the common sleep problems are difficulty in falling asleep. difficulty in maintaining sleep, sleep disturbances such as bad dreams excessively, night mares, etc, sleeping too less or too much and not feeling fresh after getting up from sleep.
In today's life style of travelling across the globe and night shifts can lead to disturbance in our body's natural circadian rhythm which can lead to jet lag, shift work sleep disorder, etc. Poor sleep quality can also be associated with cardiac events and accidents. Poor sleep can make us inattentive , irritable, distracted, restless, sleepy and groggy at our workplace and study place. A person having chronic untreated sleep problems can also have problems with efficiency and work performance.
Insomnia, Hypersomnia, Parasomnia are types of sleep disorders. Certain medical conditions, medications and substances such as alcohol, cannabis, nicotine can also interfere with sleep. Sleep disturbance is also a part of psychiatric disorders such as adjustment disorder, acute stress reaction, post traumatic stress disorder, depression, mania,psychosis, addictions, etc. Children can have bed wetting and night terrors during sleep. I have written some dos and donts which is not a fully comprehensive list, yet can be helpful for getting good sleep.
- It is preferable to stop late night use of gadgets, apps, internet, TV viewing if you are having problems in falling asleep. Learn to switch off from all of these everyday at least an hour before you go to sleep.
- Practice relaxation daily before going to sleep. Deep breathing exercises while lying on your bed with a focus on breathing slowly and being aware of each breath and slowing down your system with use of some positive images in your mind can help in falling asleep.
- Late Evening prayers can helpful for sleep based on your own belief systems.
- Eat light meals at bedtime and drinking a cup of warm milk can help in getting sleep.You may add almonds, cashew nuts, saffron, etc based on your preference. Taking a relaxing shower prior to bedtime can help sleep well.
- Do cut down on daily intake of excessive consumption of sugar, salt, oil,spices in your diet if you are experiencing severe gastrointestinal discomfort while falling asleep and also waking up at night feeling uneasy, bloated, acidity, pain in abdomen, etc.
- Monitor daily intake of tea and coffee and cut down intake if you have problems with sleep.
- Be positive at bedtime. Live for each day to its fullest ! Tell your mind positive self statements at bed time that " Yes, I am doing good! I am doing fine! Things are great! Life has been good to me! I shall conquer all my problems! No need to worry! Things are in control! Situation will get better! I can work something out! Life is beautiful! I am doing well for myself! Things will change for the best! "' These kind of positive statements said to yourself can help you gain control over negative defeating thoughts which maybe coming in your mind at bedtime while you stare at the ceiling trying to fall asleep at night especially when you are facing difficult stressful times.
- Try to cut down on smoking and chewing tobacco. Seek professional help for de-addiction from nicotine and tobacco.
- Try to cut down on alcohol if you are facing problems in sleep related to alcohol. Seek professional help in quitting alcohol. Drugs such as cannabis, cocaine, heroin, etc have harmful consequences on sleep and mental health. Seek professional help to quit from them.
- Try to have a fixed schedule of sleeping at the same time and waking up at the same time everyday. Pay attention to your bed room, clean the bed room regularly, keep changing sheets regularly and keep replacing old bed sheets, pillows, pillow covers regularly. Pay attention to the right temperature settings and dress in comfortable night clothes as per your preference.
- Do not drink excessive caffeine, tea, stimulant drinks before going to sleep or late evening if you are having problems falling asleep.
- Tobacco can interfere with sleep and avoid smoking or chewing tobacco just before going to bed. Alcohol can interfere with sleep and avoid drinking alcohol before going to bed.
- Do not indulge in drugs such as cannabis , cocaine, heroin,etc as they interfere with sleep.
- Do not eat heavy meals or drink too much water just before going to bed.
- Avoid excessive TV viewing or internet viewing just before going to sleep. Avoid excessive texting and playing online games just before going to sleep.
- Do not do excessive rigorous exercise very late evening if u are having a persistent problem in falling asleep as it can switch on certain neurotransmitters and can interfere in falling asleep for some individuals.
- Do not use your bed for eating, drinking, studying, watching TV, working/surfing on your lap top. Do not sleep with lights and gadgets on as it can cause sleep interference.
- Do not think and worry excessively about how was your day, who upset you, why u did this or that and why you shouldn't have done this or that. All these ruminations, worries, anxiety just before going to sleep will certainly affect your sleep. Do not cry or pick up quarrels with others before going to sleep as it will affect your sleep quality.
- Do not keep getting up and checking the phone, alarm clock or the watch to see what is the time again and again.
- Do not have a varied sleeping schedule which is very erratic where in one day you sleep at eleven pm the second day at one am and third day at three am. Do not take long hours of nap in the afternoon or evening as it then interferes in falling asleep at night.
If despite your best efforts, you are not able to get good sleep, kindly consult a psychiatrist. The psychiatrist will screen you for a psychiatric disorder where sleep disturbance may be a predominant symptom such as anxiety disorder, stress related disorder, depression, mania, psychosis, etc. They will assess you and provide you treatment for your sleep problems based on whether you have Insomnia, Hypersomnia or Parasomnia related conditions.
After clinically evaluating you, they may suggest some tests, teach you relaxation training, sleep hygiene therapy and psychological therapy targeting the cause of your sleep problems. They may also prescribe you medications for the sleep condition you suffer from. He/She may also refer you to a Neurologist or a Sleep Physician as per clinical expertise for conditions such as Sleep Apneas, Nocturnal Epilepsy, Narcolepsy, Restless Leg Syndrome, etc which may need a a comprehensive evaluation with Sleep Lab based assessments and multidisciplinary interventions.